A home visit program versus a non-home visit program in total knee replacement patients: a randomized controlled trial
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(2019) 14:405
RESEARCH ARTICLE
Open Access
A home visit program versus a non-home visit program in total knee replacement patients: a randomized controlled trial Bura Sindhupakorn* , Piya-on Numpaisal, Suwittaya Thienpratharn and Darawan Jomkoh
Abstract Background: The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients’ satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities. Methods: We recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient’s satisfaction score as secondary objective. The study was 6 weeks after surgery. Results: TKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P < 0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P < 0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P < 0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient’s satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P < 0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005). Conclusion: Our TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKRH improves satisfaction after total knee replacement. Trial registration: TCTR20190514001. Keywords: Home visit program, Non-home visit program, Total knee replacement
Background At present, the keys to success for a total knee replacement (TKR) include reducing pain, restoring function, and improving the quality of life [1–3]. Less pain with a wide range of motion and independence are important goals for rehabilitation [4, 5]. Due to the increase in knee replacements worldwide, there is an increasing focus on improving the cost and effectiveness of this procedure with healthcare systems. There is a strong economic pressure to reduce the length of the hospital stay making * Correspondence: [email protected] School of orthopedic, Institute of medicine, Suranaree University of Technology, 111 University Ave, Muang District, Nakhon Ratchasima, Nakhon Ratchasima 30000, Thailand
it the highest priority [6, 7]. However, some researchers have emphasized the risks with early hospital discharge of patients and its impact on their families [8]. The mean 1-year WOMAC score is lowest in the first 3 months [9]. The range of the mean 1 year WOMAC
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